1. WHOLE HUMAN BLOOD

Composition:

– RBCs

– Plasma

– Platelets (minimal)

– Coagulation factors

Indications:

Whole blood is rarely used today. It is indicated only when both oxygen-carrying capacity and blood volume must be restored together.

Appropriate Uses:

– Trauma patients with massive acute blood loss

– Major surgery with sudden hemorrhage

– Exchange transfusion (rarely)

Not Recommended:

– Chronic anemia

– Malaria

– Routine transfusion

2. PACKED RED BLOOD CELLS (PRBCs)

Composition:

Concentrated RBCs without most plasma.

Indications:

Used when the primary problem is anemia.

Appropriate Uses:

– Acute blood loss with Hb <7 g/dL

– Chronic anemia (CKD, thalassemia)

– Surgical and cardiac patients with low Hb

Not Recommended:

– Volume expansion

– Routine non-anemic conditions

3. FRESH FROZEN PLASMA (FFP)

Composition:

All coagulation factors, fibrinogen, albumin, proteins.

Indications:

– Liver disease with prolonged PT/INR and bleeding

– DIC

– Massive transfusion protocol

– Warfarin reversal when PCC unavailable

Not Recommended:

– Protein supplementation

– Volume expansion

4. CRYOPRECIPITATE

Composition:

Fibrinogen, Factor VIII, Factor XIII, vWF, fibronectin.

Indications:

– Hypofibrinogenemia

– PPH with low fibrinogen

– Liver failure

– Massive transfusion

– FXIII deficiency

5. PLATELET CONCENTRATES

Types:

– Random Donor Platelet (RDP)

– Single Donor Platelet (SDP)

Indications:

– Dengue with thrombocytopenia

– Chemotherapy-induced thrombocytopenia

– Aplastic anemia

– Surgical patients with low platelets

– Massive transfusion

Not Recommended:

– ITP unless severe bleeding

6. GRANULOCYTE CONCENTRATES

Indications:

– Severe neutropenia

– Documented bacterial/fungal infections not responding to antibiotics.

7. LEUKOREDUCED PRODUCTS

Indications:

– Thalassemia major

– Oncology patients

– Renal transplant recipients

– Previous FNHTR reactions

8. IRRADIATED BLOOD PRODUCTS

Indications:

– Bone marrow transplant patients

– Immunocompromised individuals

– Intrauterine and neonatal exchange transfusions

– Transfusions from first-degree relatives

9. WASHED RBCs

Indications:

– Recurrent allergic reactions

– IgA deficiency with anti-IgA antibodies

– Neonatal transfusions

10. SPECIAL CONSIDERATIONS BY DISEASE

Dengue:

– Platelets based on threshold

– Avoid whole blood unless bleeding with coagulopathy

Malaria:

– PRBC only

Thalassemia:

– Regular leukoreduced PRBCs

CKD:

– PRBC to correct anemia

Liver Disease:

– FFP, cryoprecipitate, platelets depending on deficiency